THE DIFFERENT CLINICAL FORMS

 THE DIFFERENT CLINICAL FORMS   1.2.   Shapes according to age   1.2.1.   Latency phase depression: depression in school-age children   Often occurring following an   event representing loss or bereavement (separation of parents, death of a grandparent, a member of   siblings or a parent), sometimes an event which may appear to adults appear more innocuous   (moving,   death of a pet, etc.), depression in children often sets in gradually with symptoms belonging to   several registers.   The great clinical polymorphism at this age gives depression a misleading appearance. However, the   child's behavior appears clearly modified compared to his premorbid state. The clinical picture   combines several symptoms in the following registers: Sadness of mood and boredom: sadness is   often replaced by attacks of anger, or even lability of mood. Irritability often takes the form of anger   or opposition.   Devaluation and loss of self-esteem :   We note an exacerbated sensitivity to imperfections and/or   failures.   Child's activities are often accompanied by negative comments, self-deprecation, and/or a feeling of   inadequacy and worthlessness.   Loss  of  interest  and  pleasure:   are  rather  manifested  by  attitudes  of  withdrawal,  disinterest,  passivity:   in  the  depressed  child  there  is  a  loss  of  interest  in  some  or  all  of  the  activities  which  could  be  a  source   of pleasure for him.   Motor behavior disorders   : most often, we notice instability or agitation. Psychomotor slowing and   motor inhibition are much rarer. Academic difficulties:   Attentional   and   memory   difficulties   can   lead   to   decline   or   even   academic   failure.   They   must   be   mentioned in the face of secondary avoidance or refusal of school work.   Repeated   somatic   complaints   type   of   abdominal   pain   and   headaches   which   may   precede   the   symptoms and for which no organic cause is found.   Conduct disorder :   type of lies, theft, hetero-aggression, even running away. 

 Suicidal   ideation   and   equivalents:   depressed   children   have   a   marked   propensity   for   fractures,   accidents  and  injuries.  These  manifestations  can  be  considered  suicidal  equivalents.  Sometimes,  ideas   of   death   or  suicide  can  be  expressed  directly  or  manifest  themselves  more  rarely,  through  a  suicidal   act which should never be underestimated.   Appetite disorders :   type of anorexia, snacking or hyperphagia.   Sleep disorders :   They vary from insomnia to falling asleep, refusal to go to bed, broken sleep and/or   nightmares.   Sphincter disorders :   type of secondary encopresis and/or secondary enuresis. The positive diagnosis   is based on history, family interview and clinical examination. Each of these signs taken in isolation   is not necessarily indicative of the depressive episode.   It  is  the  association  of  at  least  five  of  the  symptoms  (with  at  least  one  of  the  symptoms  is  either   the   change  in  mood  or  the  loss  of  interest  or  pleasure),   their   permanence   in  time  (for  at  least  two   weeks)  and  the   modification   net  behavioral  that  they  induce  in  relation  to  the  behavior   prior,   which  is   characteristicand which will make it possible to diagnose depression in children.